Real-time video mosaicing with a high-resolution microendoscope

Microendoscopes allow clinicians to view subcellular features in vivo and in real-time, but their field-of-view is inherently limited by the small size of the probe's distal end. Video mosaicing has emerged as an effective technique to increase the acquired image size. Current implementations are performed post-procedure, which removes the benefits of live imaging. In this manuscript we present an algorithm for real-time video mosaicing using a low-cost high-resolution microendoscope. We present algorithm execution times and show image results obtained from in vivo tissue

Development of a single-board computer high-resolution microendoscope (PiHRME) to increase access to cervical cancer screening in underserved areas

Over 85% of cervical cancer deaths occur in developing countries.1 Even though the early detection and treatment of cervical precancerous lesions has been shown to prevent invasive cervical cancer, limited resources make it difficult to implement standard cervical cancer screening methods, such as the Pap Smear, in low-resource areas. Instead, many developing countries rely on the visual inspection of the cervix with acetic acid (VIA) to help identify precancerous and cancerous lesions. While VIA has a high sensitivity (82.14%), it has a poor specificity (50.00%), resulting in the overtreatment of women and misallocation of limited resources.2 Recent studies have shown that combining VIA with high-resolution microendoscope (HRME) imaging increases the specificity of cervical cancer screening.3-4 The HRME is a low-cost imaging system (~$2,100) that allows the user to image epithelial tissue in vivo at sub-cellular resolutions at the point-of-care. The current HRME imaging system is also accompanied with automatic image analysis software to distinguish normal and low-grade lesions from high-grade precancerous and cancerous lesions of the cervix. Please click Additional Files below to see the full abstract

Reducing Pulmonary Function Testing Procedure Times in Pediatric Patients

Problem. The Pulmonary Function Test Time Project (PFT Project) is a quality improvement (QI) initiative designed to decrease PFT testing time and PFT total time in pediatric patients and improve the overall process for both providers and patients. Patients scheduled to see a pulmonary provider were also scheduled for a PFT prior to the provider’s visit. Data showed that the length of time to perform a pulmonary function test (PFT) was causing: (1) a delay in the pulmonary provider seeing patients at the intended appointment time, (2) a disruption to clinic workflow, resulting in scheduling difficulties, and (3) a decreased number of patients seen by the providers. Any delays with the PFT appointment could have a negative impact on the flow of clinic appointments. The aim of the PFT Project was to reduce the length of time for pulmonary function testing without compromising the quality of the test results. Methods. The initiative applied a quality improvement approach using Plan, Do, Study, Act (PDSA) cycles to implement a change plan and achieve desired project outcomes. Monthly reports showing average PFT testing time, average PFT total time, and acceptability and repeatability (A/R) percent success rates were generated and utilized to discuss goal progress and to celebrate successes with the PFT lab team. Results. 2973 patients were included in the procedure time portion of the initiative, and 4874 patients were included in the A/R percent success rate portion of the analysis. The average PFT testing time and average PFT total time were reduced by 49% and 24%, respectively, for spirometry. The average PFT testing time and average PFT total time for spirometry before and after administration of a bronchodilator (B&A BD) were reduced by 23% and 15%, respectively. There was an improvement in the acceptability and repeatability percent success rate within 22 months of initiating the project. Conclusion. The implementation of improved PFT lab processes allowed us to meet the desired goal to decrease PFT testing time and PFT total time for both spirometry and spirometry B&A BD testing without negatively impacting quality

2020 Media Futures

What will our media and entertainment be like in 2020

Alteration of Retinal Rod Outer Segment Membrane Fluidity in a Rat Model of Smith-Lemli-Opitz Syndrome

Smith-Lemli-Opitz syndrome (SLOS) is caused by an inherited defect in the last step in cholesterol (Chol) biosynthesis, leading to abnormal accumulation of 7-dehydrocholesterol and decreased Chol levels. Progressive retinal degeneration occurs in an animal model of SLOS, induced by treating rats with AY9944, a selective inhibitor of the enzyme affected in SLOS. Here we evaluated alterations in the biochemical and physical properties of retinal rod outer segment (ROS) membranes in this animal model. At 1 month of AY9944 treatment, there were modest alterations in fatty acid composition, but no significant differences in cis-parinaric acid (cPA) spectroscopic parameters in ROS membranes from treated versus control rats. However, at 3 months, ROS docosahexaenoic acid (DHA) content was dramatically reduced, and cPA fluorescence anisotropy values were decreased, relative to controls. Also, 1, 6-diphenyl-1, 3, 5-hexatriene exhibited decreased rotational motion and increased orientational order in ROS membranes from 3 month-old AY9944-treated rats, relative to controls. No significant changes in protein:lipid ratios were observed; however, rhodopsin regenerability was compromised by 3 months of treatment. These findings are consistent with reduced ROS membrane fluidity in the SLOS rat model, relative to controls, primarily due to the dramatic reduction inmembraneDHA levels, rather than altered sterol composition

Stakeholders\u27 views on data sharing in multicenter studies

AIM: To understand stakeholders\u27 views on data sharing in multicenter comparative effectiveness research studies and the value of privacy-protecting methods. MATERIALS and METHODS: Semistructured interviews with five US stakeholder groups. RESULTS: We completed 11 interviews, involving patients (n = 15), researchers (n = 10), Institutional Review Board and regulatory staff (n = 3), multicenter research governance experts (n = 2) and healthcare system leaders (n = 4). Perceptions of the benefits and value of research were the strongest influences toward data sharing; cost and security risks were primary influences against sharing. Privacy-protecting methods that share summary-level data were acknowledged as being appealing, but there were concerns about increased cost and potential loss of research validity. CONCLUSION: Stakeholders were open to data sharing in multicenter studies that offer value and minimize security risks

Co-constructing Simulations with Learners: Roles, Responsibilities, and Impact

Co-constructed simulations were designed and piloted with senior occupational therapy master’s students in a neurorehabilitation practice module. The instructor served as the guide for the students through all phases of the case creation, simulation development, delivery, and debrief. The instructor facilitation promoted self-regulated learning (SRL) of knowledge and skill development through independent discovery and peer learning. This paper provides an evidence-informed co-construction simulation design with outlined stages, roles, and responsibilities for the instructor and learner. Thematic qualitative analysis of student feedback highlighted enhanced insight and SRL as a result of multiple role preparation, observation and interaction with peers, close interaction with the instructor, and the multi-stage debrief process. Recommended key features and critical interactions for a successful co-constructed design are also identified for the learner, instructor, and simulation. The co-construction simulation process and design elements are suitable for learners in any health-related field of study

An observational treatment study of metacognition in anxious-depression

Prior studies have found metacognitive biases are linked to a transdiagnostic dimension of anxious-depression, manifesting as reduced confidence in performance. However, previous work has been cross-sectional and so it is unclear if under-confidence is a trait-like marker of anxious-depression vulnerability, or if it resolves when anxious-depression improves. Data were collected as part of a large-scale transdiagnostic, four-week observational study of individuals initiating internet-based cognitive behavioural therapy (iCBT) or antidepressant medication. Self-reported clinical questionnaires and perceptual task performance were gathered to assess anxious-depression and metacognitive bias at baseline and 4-week follow-up. Primary analyses were conducted for individuals who received iCBT (n=649), with comparisons between smaller samples that received antidepressant medication (n=82) and a control group receiving no intervention (n=88). Prior to receiving treatment, anxious-depression severity was associated with under-confidence in performance in the iCBT arm, replicating previous work. From baseline to follow-up, levels of anxious-depression were significantly reduced, and this was accompanied by a significant increase in metacognitive confidence in the iCBT arm (β=0.17, SE=0.02, p<0.001). These changes were correlated (r(647)=-0.12, p=0.002); those with the greatest reductions in anxious-depression levels had the largest increase in confidence. While the three-way interaction effect of group and time on confidence was not significant (F(2, 1632)=0.60, p=0.550), confidence increased in the antidepressant group (β=0.31, SE = 0.08, p<0.001), but not among controls (β=0.11, SE = 0.07, p=0.103). Metacognitive biases in anxious-depression are state-dependent; when symptoms improve with treatment, so does confidence in performance. Our results suggest this is not specific to the type of intervention

An observational treatment study of metacognition in anxious-depression

Prior studies have found metacognitive biases are linked to a transdiagnostic dimension of anxious-depression, manifesting as reduced confidence in performance. However, previous work has been cross-sectional and so it is unclear if under-confidence is a trait-like marker of anxious-depression vulnerability, or if it resolves when anxious-depression improves. Data were collected as part of a large-scale transdiagnostic, four-week observational study of individuals initiating internet-based cognitive behavioural therapy (iCBT) or antidepressant medication. Self-reported clinical questionnaires and perceptual task performance were gathered to assess anxious-depression and metacognitive bias at baseline and 4-week follow-up. Primary analyses were conducted for individuals who received iCBT (n=649), with comparisons between smaller samples that received antidepressant medication (n=82) and a control group receiving no intervention (n=88). Prior to receiving treatment, anxious-depression severity was associated with under-confidence in performance in the iCBT arm, replicating previous work. From baseline to follow-up, levels of anxious-depression were significantly reduced, and this was accompanied by a significant increase in metacognitive confidence in the iCBT arm (β=0.17, SE=0.02, p<0.001). These changes were correlated (r(647)=-0.12, p=0.002); those with the greatest reductions in anxious-depression levels had the largest increase in confidence. While the three-way interaction effect of group and time on confidence was not significant (F(2, 1632)=0.60, p=0.550), confidence increased in the antidepressant group (β=0.31, SE = 0.08, p<0.001), but not among controls (β=0.11, SE = 0.07, p=0.103). Metacognitive biases in anxious-depression are state-dependent; when symptoms improve with treatment, so does confidence in performance. Our results suggest this is not specific to the type of intervention